– Eleven members of the Mirza Gul family, 10 of them children, gathered around an unfamiliar object outside their home. It was 6 a.m. April 29, and the night before, the Taliban had fought Afghan soldiers nearby.

Two small children picked it up, and 16-year-old Jalil realized immediately that it was dangerous: an unexploded rocket. He tried to wrest it away from them, but in the tussle, it fell and exploded.

It was a cruel day, even by the standards of Afghanistan’s long war.

By day’s end, four were dead, including Jalil, who had tried to save them all and died in the hospital. One 4-year-old girl, Marwa, lost both her twin sister, Safwa, and their mother, Brekhna, who had been nearby making dung cakes for fuel. One of Brekhna’s nieces, a 6-year-old, was also killed.

Seven survivors — three brothers and four of their first cousins — were left to bear the weight of those losses, and more: Every one of them lost a leg, and two lost both.

Through the next two days, doctors at the Nangarhar Regional Hospital in Jalalabad worked trying to repair mangled limbs, then sometimes amputated them after finding they could not be saved.

“I wanted to cry in the OT,” said the chief of the orthopedic service, Dr. Sayed Bilal Miakhel. “We have many amputations here, but this was children and all from the same family.”

Abdul Rashid, 12, remembers when he regained consciousness after the blast. “I tried to stand up and my legs were gone,” he said. His younger brother Mangal, 11, said he hobbled on his knees toward their home after the blast, but passed out and awoke in the hospital.

Most of those with amputations below their knees will be good candidates for artificial limbs. Still, none can be fitted until several months of healing. Meanwhile, the children have had repeated operations to address complications, periodically sharing four beds in one hospital room. Some are already well enough to go home at night to their village, Fateh Abad, but three need long-term hospitalization.

To distinguish them, doctors have written their names in marker pen on their chests.

“We can save their lives, but for rehabilitation and treatment, if they could be transferred to a well-equipped center, it would be better,” said Dr. Najibullah Kamawal, the head of the Nangarhar Public Health Department. “Probably in another country. Every one of them needs one-on-one help. And these are such poor people.”

Shafiqullah, 13, had above-the-knee amputations to both legs and was begging doctors to let him go home. They said he faces two more operations before that will be possible.

The teenager was particularly worried about his school studies. Exams are about to start for his sixth-grade class, and he insisted that his family bring in his books and papers so he could keep up. “I don’t want to miss my exams.”

The family’s home village remains on the front lines of the fight between the Taliban and the government. The family doesn’t know which side is responsible.

“It just goes on,” said Hamisha Gul, 65, the father of Jalil, who died, and of three brothers with amputated limbs. “We don’t know whom to blame.”